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Discoid lupus erythematosus

MedGen UID:
1811126
Concept ID:
C5574816
Disease or Syndrome
Synonym: Discoid lupus rash
SNOMED CT: Discoid lupus erythematosus (200938002); DLE - Discoid lupus erythematosus (200938002); LE - Discoid lupus erythematosus (200938002)
 
HPO: HP:0007417
Monarch Initiative: MONDO:0019558
Orphanet: ORPHA90281

Definition

Cutaneous lesion that develops as a dry, scaly, red patch that evolves to an indurated and hyperpigmented plaque with adherent scale. Scarring may result in central white patches (loss of pigmentation) and skin atrophy. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • Discoid lupus erythematosus

Conditions with this feature

Granulomatous disease, chronic, X-linked
MedGen UID:
336165
Concept ID:
C1844376
Disease or Syndrome
Chronic granulomatous disease (CGD) is a primary immunodeficiency disorder of phagocytes (neutrophils, monocytes, macrophages, and eosinophils) resulting from impaired killing of bacteria and fungi. CGD is characterized by severe recurrent bacterial and fungal infections and dysregulated inflammatory responses resulting in granuloma formation and other inflammatory disorders such as colitis. Infections typically involve the lung (pneumonia), lymph nodes (lymphadenitis), liver (abscess), bone (osteomyelitis), and skin (abscesses or cellulitis). Granulomas typically involve the genitourinary system (bladder) and gastrointestinal tract (often the pylorus initially, and later the esophagus, jejunum, ileum, cecum, rectum, and perirectal area). Some males with X-linked CGD have McLeod neuroacanthocytosis syndrome as the result of a contiguous gene deletion. While CGD may present anytime from infancy to late adulthood, the vast majority of affected individuals are diagnosed before age five years. Use of antimicrobial prophylaxis and therapy has greatly improved overall survival.
Granulomatous disease, chronic, autosomal recessive, cytochrome b-positive, type 2
MedGen UID:
383869
Concept ID:
C1856245
Disease or Syndrome
Chronic granulomatous disease (CGD) is a primary immunodeficiency disorder of phagocytes (neutrophils, monocytes, macrophages, and eosinophils) resulting from impaired killing of bacteria and fungi. CGD is characterized by severe recurrent bacterial and fungal infections and dysregulated inflammatory responses resulting in granuloma formation and other inflammatory disorders such as colitis. Infections typically involve the lung (pneumonia), lymph nodes (lymphadenitis), liver (abscess), bone (osteomyelitis), and skin (abscesses or cellulitis). Granulomas typically involve the genitourinary system (bladder) and gastrointestinal tract (often the pylorus initially, and later the esophagus, jejunum, ileum, cecum, rectum, and perirectal area). Some males with X-linked CGD have McLeod neuroacanthocytosis syndrome as the result of a contiguous gene deletion. While CGD may present anytime from infancy to late adulthood, the vast majority of affected individuals are diagnosed before age five years. Use of antimicrobial prophylaxis and therapy has greatly improved overall survival.
Granulomatous disease, chronic, autosomal recessive, cytochrome b-positive, type 1
MedGen UID:
341102
Concept ID:
C1856251
Disease or Syndrome
Chronic granulomatous disease (CGD) is a primary immunodeficiency disorder of phagocytes (neutrophils, monocytes, macrophages, and eosinophils) resulting from impaired killing of bacteria and fungi. CGD is characterized by severe recurrent bacterial and fungal infections and dysregulated inflammatory responses resulting in granuloma formation and other inflammatory disorders such as colitis. Infections typically involve the lung (pneumonia), lymph nodes (lymphadenitis), liver (abscess), bone (osteomyelitis), and skin (abscesses or cellulitis). Granulomas typically involve the genitourinary system (bladder) and gastrointestinal tract (often the pylorus initially, and later the esophagus, jejunum, ileum, cecum, rectum, and perirectal area). Some males with X-linked CGD have McLeod neuroacanthocytosis syndrome as the result of a contiguous gene deletion. While CGD may present anytime from infancy to late adulthood, the vast majority of affected individuals are diagnosed before age five years. Use of antimicrobial prophylaxis and therapy has greatly improved overall survival.
Granulomatous disease, chronic, autosomal recessive, cytochrome b-negative
MedGen UID:
383872
Concept ID:
C1856255
Disease or Syndrome
Chronic granulomatous disease (CGD) is a primary immunodeficiency disorder of phagocytes (neutrophils, monocytes, macrophages, and eosinophils) resulting from impaired killing of bacteria and fungi. CGD is characterized by severe recurrent bacterial and fungal infections and dysregulated inflammatory responses resulting in granuloma formation and other inflammatory disorders such as colitis. Infections typically involve the lung (pneumonia), lymph nodes (lymphadenitis), liver (abscess), bone (osteomyelitis), and skin (abscesses or cellulitis). Granulomas typically involve the genitourinary system (bladder) and gastrointestinal tract (often the pylorus initially, and later the esophagus, jejunum, ileum, cecum, rectum, and perirectal area). Some males with X-linked CGD have McLeod neuroacanthocytosis syndrome as the result of a contiguous gene deletion. While CGD may present anytime from infancy to late adulthood, the vast majority of affected individuals are diagnosed before age five years. Use of antimicrobial prophylaxis and therapy has greatly improved overall survival.
Complement component C1r/C1s deficiency
MedGen UID:
461624
Concept ID:
C3150274
Disease or Syndrome
Lack of production of either functional C1r or C1s protein, due to a genetic defect. Approximately 60% of patients with a C1r/C1s deficiency will develop a severe systemic lupus erythematosus at an early age. Patients also present with frequent sinopulmonary infections often with Streptococcus pneumoniae.
Autoinflammatory disease, multisystem, with immune dysregulation, X-linked
MedGen UID:
1840213
Concept ID:
C5829577
Disease or Syndrome
X-linked multisystem autoinflammatory disease with immune dysregulation (ADMIDX) is an X-linked recessive disorder with onset of symptoms in infancy or early childhood. Affected individuals may present with variable cytopenias, including anemia, thrombocytopenia, neutropenia, lymphopenia, or hypogammaglobulinemia, and systemic or organ-specific autoinflammatory manifestations. These include skin lesions, panniculitis, inflammatory bowel disease, pulmonary disease, or arthritis associated with recurrent fever, leukocytosis, lymphoproliferation, and hepatosplenomegaly in the absence of an infectious agent. Some patients have circulating autoantibodies that underlie the cytopenias or systemic features, whereas others do not have circulating autoantibodies. In addition, some patients have recurrent infections, whereas others do not show signs of an immunodeficiency. Laboratory studies are consistent with immune dysregulation, including altered B-cell subsets and variably elevated proinflammatory cytokines. Detailed functional studies of platelets, red cells, and T lymphocytes suggest that abnormal actin cytoskeleton remodeling is a basic defect, indicating that this disorder can be classified as an immune-related actinopathy. Severe complications of the disease may result in death in childhood (Boussard et al., 2023; Block et al., 2023).
C1Q deficiency 2
MedGen UID:
1841058
Concept ID:
C5830422
Disease or Syndrome
C1q deficiency (C1QD) is a rare autosomal recessive disorder characterized by recurrent skin lesions, chronic infections, and an increased risk of autoimmune diseases, particularly systemic lupus erythematosus (SLE; see 152700) or SLE-like diseases. It has also been associated with chronic glomerulonephritis and renal failure. C1q deficiency presents in 2 different forms, absent C1q protein or presence of a dysfunctional molecule (summary by Topaloglu et al., 1996 and Vassallo et al., 2007). For a discussion of genetic heterogeneity of C1q deficiency, see 613652.
C1Q deficiency 3
MedGen UID:
1841059
Concept ID:
C5830423
Disease or Syndrome
C1q deficiency (C1QD) is a rare autosomal recessive disorder characterized by recurrent skin lesions, chronic infections, and an increased risk of autoimmune diseases, particularly systemic lupus erythematosus (SLE; see 152700) or SLE-like diseases. It has also been associated with chronic glomerulonephritis and renal failure. C1q deficiency presents in 2 different forms, absent C1q protein or presence of a dysfunctional molecule (summary by Topaloglu et al., 1996 and Vassallo et al., 2007). For a discussion of genetic heterogeneity of C1q deficiency, see 613652.

Professional guidelines

PubMed

Carrozzo M, Porter S, Mercadante V, Fedele S
Periodontol 2000 2019 Jun;80(1):105-125. doi: 10.1111/prd.12260. PMID: 31090143
Garza-Mayers AC, McClurkin M, Smith GP
Dermatol Ther 2016 Jul;29(4):274-83. Epub 2016 Apr 12 doi: 10.1111/dth.12358. PMID: 27073142
Okon LG, Werth VP
Best Pract Res Clin Rheumatol 2013 Jun;27(3):391-404. doi: 10.1016/j.berh.2013.07.008. PMID: 24238695Free PMC Article

Recent clinical studies

Therapy

Russo G, Alipour Tehrany Y
N Engl J Med 2024 Sep 26;391(12):e24. doi: 10.1056/NEJMicm2402680. PMID: 39321365
Jiménez-Antón A, Jiménez-Gallo D, Millán-Cayetano JF, Navarro-Navarro I, Linares-Barrios M
Lupus 2023 Mar;32(3):438-440. Epub 2023 Jan 9 doi: 10.1177/09612033221151011. PMID: 36623176
Nassim D, Alajmi A, Jfri A, Pehr K
Dermatol Ther 2020 Nov;33(6):e14261. Epub 2020 Sep 27 doi: 10.1111/dth.14261. PMID: 32876993
Jessop S, Whitelaw DA, Grainge MJ, Jayasekera P
Cochrane Database Syst Rev 2017 May 5;5(5):CD002954. doi: 10.1002/14651858.CD002954.pub3. PMID: 28476075Free PMC Article
Okon LG, Werth VP
Best Pract Res Clin Rheumatol 2013 Jun;27(3):391-404. doi: 10.1016/j.berh.2013.07.008. PMID: 24238695Free PMC Article

Prognosis

Alessandrini A, Bruni F, Piraccini BM, Starace M
J Eur Acad Dermatol Venereol 2021 Mar;35(3):629-640. Epub 2021 Jan 8 doi: 10.1111/jdv.17079. PMID: 33290611
Zhou W, Wu H, Zhao M, Lu Q
Expert Rev Clin Immunol 2020 Aug;16(8):829-837. Epub 2020 Sep 29 doi: 10.1080/1744666X.2020.1805316. PMID: 32746644
Carrozzo M, Porter S, Mercadante V, Fedele S
Periodontol 2000 2019 Jun;80(1):105-125. doi: 10.1111/prd.12260. PMID: 31090143
Warnakulasuriya S
Oral Surg Oral Med Oral Pathol Oral Radiol 2018 Jun;125(6):582-590. Epub 2018 Apr 4 doi: 10.1016/j.oooo.2018.03.011. PMID: 29673799
Mubki T, Rudnicka L, Olszewska M, Shapiro J
J Am Acad Dermatol 2014 Sep;71(3):415.e1-415.e15. doi: 10.1016/j.jaad.2014.04.070. PMID: 25128118

Clinical prediction guides

Lee JH, Ju HJ, Seo JM, Almurayshid A, Kim GM, Ezzedine K, Bae JM
J Invest Dermatol 2023 May;143(5):777-789.e6. Epub 2022 Nov 28 doi: 10.1016/j.jid.2022.10.021. PMID: 36574529
Zheng M, Hu Z, Mei X, Ouyang L, Song Y, Zhou W, Kong Y, Wu R, Rao S, Long H, Shi W, Jing H, Lu S, Wu H, Jia S, Lu Q, Zhao M
Nat Commun 2022 Dec 5;13(1):7489. doi: 10.1038/s41467-022-35209-1. PMID: 36470882Free PMC Article
Arif T, Fatima R, Sami M
Australas J Dermatol 2022 Nov;63(4):452-462. Epub 2022 Aug 11 doi: 10.1111/ajd.13890. PMID: 35950883
Kinoshita-Ise M, Sachdeva M
J Dermatol 2022 Jan;49(1):4-18. Epub 2021 Nov 22 doi: 10.1111/1346-8138.16233. PMID: 34806223
Zhou W, Wu H, Zhao M, Lu Q
Expert Rev Clin Immunol 2020 Aug;16(8):829-837. Epub 2020 Sep 29 doi: 10.1080/1744666X.2020.1805316. PMID: 32746644

Recent systematic reviews

Lee JH, Ju HJ, Seo JM, Almurayshid A, Kim GM, Ezzedine K, Bae JM
J Invest Dermatol 2023 May;143(5):777-789.e6. Epub 2022 Nov 28 doi: 10.1016/j.jid.2022.10.021. PMID: 36574529
Kinoshita-Ise M, Sachdeva M
J Dermatol 2022 Jan;49(1):4-18. Epub 2021 Nov 22 doi: 10.1111/1346-8138.16233. PMID: 34806223
Hawat T, Ballouz S, Megarbane H, Haber R
Dermatol Ther 2022 Jan;35(1):e15170. Epub 2021 Nov 17 doi: 10.1111/dth.15170. PMID: 34676640
Żychowska M, Żychowska M
Int J Dermatol 2021 Jul;60(7):818-828. Epub 2020 Dec 15 doi: 10.1111/ijd.15365. PMID: 33319363
Jessop S, Whitelaw DA, Grainge MJ, Jayasekera P
Cochrane Database Syst Rev 2017 May 5;5(5):CD002954. doi: 10.1002/14651858.CD002954.pub3. PMID: 28476075Free PMC Article

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